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Research article
Value of biomarkers in the diagnosis of community-acquired pneumonia with concomitant chronic heart failure: a prospective observation study.
Svetlana Rachina
Rossijskij universitet druzby narodov Medicinskij institut
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3329-7846
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The diagnosis of community-acquired pneumonia (CAP) in patients with chronic heart failure (CHF) is associated with objective difficulties due to similar clinical presentation. We aimed to evaluate the utility of serum biomarkers - С-reactive protein (CRP), procalcitonin (PCT), tumour necrosis factor α (TNFα), interleukin-6 (IL-6) and brain natriuretic peptide (BNP) in diagnosis of CAP in the presence of СHF.
Methods
Prospective observational study included patients with previously diagnosed CHF and suspected non-severe CAP. Participants underwent routine procedures and chest multispiral computed tomography (MSCT); serum levels of biomarkers (CRP, PCT, TNFα, IL-6) and BNP were measured. All patients were divided into group 1 with confirmed CAP and group 2 with excluded CAP according to MSCT findings. Standard statistical tools were applied, p-value <0.05 in two-tailed tests was considered statistically significant. The value of biomarkers was determined using logistic regression, their discriminatory efficacy was assessed by analyzing Receiver Operation Characteristic (ROC) curves.
Results
Altogether 35 with CAP (median age 78 (64-82) years, female 24/35 (68.6%)) and 35 - without CAP (median age 77 (71-82) years, female 22/35 (62.9%)) were enrolled. There were no differences between groups in baseline characteristics, with the exception of body temperature. We found significantly higher levels of CRP 50.0 (35.5-98.5) mg/L, PCT 0.10 (0.05-0.54) ng/mL and IL-6 46.1 (21.4-150.3) pg/mL in group 1 as compared to group 2 - 15.0 (9.5-25.0) mg/L, 0.05 (0.05-0.05) ng/mL and 13,6 (9,5; 25,0) pg/mL, respectively. AUC (95% CI) was the highest for CRP – 0.91 (0.83-0.98), followed by PCT – 0.81 (0.72-0.90) and IL-6 – 0.81 (0.71-0.91). CRP value of 28.5 mg/L had optimal sensitivity and specificity ratio (85.7/91.4%).
Conclusion
The measurement of serum CRP, PCT, IL-6 levels can be useful for diagnostics of CAP in patients with concomitant CHF. CRP had the optimal diagnostic utility in this population. Key words: community-acquired pneumonia, chronic heart failure, inflammatory biomarkers
Keywords
community-acquired pneumonia, chronic heart failure, inflammatory biomarkers
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This is a preprint. It has not completed peer review.
Research article
Value of biomarkers in the diagnosis of community-acquired pneumonia with concomitant chronic heart failure: a prospective observation study.
Svetlana Rachina
Rossijskij universitet druzby narodov Medicinskij institut
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3329-7846
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 09 Jan, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pulmonology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The diagnosis of community-acquired pneumonia (CAP) in patients with chronic heart failure (CHF) is associated with objective difficulties due to similar clinical presentation. We aimed to evaluate the utility of serum biomarkers - С-reactive protein (CRP), procalcitonin (PCT), tumour necrosis factor α (TNFα), interleukin-6 (IL-6) and brain natriuretic peptide (BNP) in diagnosis of CAP in the presence of СHF.
Methods
Prospective observational study included patients with previously diagnosed CHF and suspected non-severe CAP. Participants underwent routine procedures and chest multispiral computed tomography (MSCT); serum levels of biomarkers (CRP, PCT, TNFα, IL-6) and BNP were measured. All patients were divided into group 1 with confirmed CAP and group 2 with excluded CAP according to MSCT findings. Standard statistical tools were applied, p-value <0.05 in two-tailed tests was considered statistically significant. The value of biomarkers was determined using logistic regression, their discriminatory efficacy was assessed by analyzing Receiver Operation Characteristic (ROC) curves.
Results
Altogether 35 with CAP (median age 78 (64-82) years, female 24/35 (68.6%)) and 35 - without CAP (median age 77 (71-82) years, female 22/35 (62.9%)) were enrolled. There were no differences between groups in baseline characteristics, with the exception of body temperature. We found significantly higher levels of CRP 50.0 (35.5-98.5) mg/L, PCT 0.10 (0.05-0.54) ng/mL and IL-6 46.1 (21.4-150.3) pg/mL in group 1 as compared to group 2 - 15.0 (9.5-25.0) mg/L, 0.05 (0.05-0.05) ng/mL and 13,6 (9,5; 25,0) pg/mL, respectively. AUC (95% CI) was the highest for CRP – 0.91 (0.83-0.98), followed by PCT – 0.81 (0.72-0.90) and IL-6 – 0.81 (0.71-0.91). CRP value of 28.5 mg/L had optimal sensitivity and specificity ratio (85.7/91.4%).
Conclusion
The measurement of serum CRP, PCT, IL-6 levels can be useful for diagnostics of CAP in patients with concomitant CHF. CRP had the optimal diagnostic utility in this population. Key words: community-acquired pneumonia, chronic heart failure, inflammatory biomarkers
Figure 2
Figure 4
Figure 6
Figure 8
Figure 10
Figure 12